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Lacrimal Gland Mistakenly Removed?

asked 3 years ago by dog in ca
Latest answer by Chris Thiagarajah, MD
Question viewed 2,195 times
Tags: gland, risk

Can a lacrimal gland be mistakenly removed thru an eyelid lift? How common is this problem? Is there any test that can be done to see if the glands are still in? Thank you very much.

16 answers to Lacrimal Gland Mistakenly Removed?

Bad complication

The lacrimal gland is located in the lateral part of the orbit. Part of the eye muscle used to lift the eyelid sits between two lobes of the lacrimal gland. To remove it during blepharoplasty is an almost unheard of complication. It is technically possible and I am sure somewhere in the history of eyelid surgery, someone has done it. The consequences can be disasterous in that the production of tears would be gone from the eye and the eye. More commonly, I have seen a few patients who... more

Chris Thiagarajah, MD
Washington DC Oculoplastic Surgeon

Anatomical position makes it nearly impossible to remove

The lacrimal gland can be mistakenly removed from a blepharoplasty. However, it is in such an anatomical position that it is nearly impossible to remove. It is located very lateral in the eyelid nowhere near the orbital fat and has a different consistency than normal fat. If it is removed, dry eyes will ensue. It is a good idea to have a Schirmer test by your ophthalmologist to determine where the functioning tear production is in your eyelids.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Lacrimal gland removal by mistake is unlikely

The lacrimal gland is tucked up under the rim of the orbital vault laterally and is difficult to access through a standard upper blepharoplasty incision. This complication is rare at best. Only in very elderly patients is ptosis (or drooping ) of the lacrimal gland common. In that scenario an experienced surgeon would need to be aware of the possibility of its anatomic location only, and still this would be an unlikely complication.

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon

www.valleyfacialplasticsurgery.com

Unlikely to remove lacrimal gland due to location

The lacrimal gland is located at the far end of the blepharoplasty incision and is usually tucked under the eye socket. As such it is difficult to reach even if you tried to remove it which makes its removal unlikely. Drier eyes can be common after blepharoplasty so do use humidifying agents like dura tears until the situation improves.

Richard Gentile, MD
Cleveland Facial Plastic Surgeon

www.facialplastics.org

Very unusual.

It is possible that the lacrimal glad was removed, but very unusual and very unlikely. However, if there is any question, then you should see an ophthalmologist. In the mean time, it is very important the you keep your eyes well-lubricated with liquid tears or some other lubricating product to prevent further problems. Good luck.

David Shafer, MD
New York Plastic Surgeon

Lacrimal probably not removed by mistake

It would be quite difficult for a qualified surgeon to remove the lacrimal gland during blepharoplasty. The gland sits in the lateral aspect of the orbit and the fat is in the middle and medial areas. Dry eyes after blepharoplasty is more likely due to a change in the tear film due to swelling and inflammation and a change in the muscular contraction of the upper lid. The effects if mild are usually temporary, but it should certainly be followed by an ophthalmologist to ensure that the... more

Andrew Miller, MD
Edison Facial Plastic Surgeon

www.associatesinplasticsurgery.com

Yes and No

Okay when your plastic surgeon did your upper lid bleph he/she intended to remove fat as well. There are two compartments in the upper lid, the third is occupied by the lacrimal gland. The fat and gland look sligtly different but only to those of us who appreciate it. So go see an opthalmologist to get your tear secretion tested. If too much was removed you will need to use lubricating drops indefinately. Good luck.

Christopher L. Hess, MD
Fairfax Plastic Surgeon

Dry eye is usually temporary

It would be highly unlikely that the lacrimal gland was removed by mistake. The upper eyelid anatomy is very straight forward. Most well qualified Plastic surgeons will only remove a small amount of fat from the medial fat pad of the upper lid (if at a all). The lacrimal gland is much further lateral and has a very different consistency. Dry eye after blepharoplasty can be a complication in anyone. More common in those who have poor tear production prior to surgery. Tear production can... more

Robert M. Jensen, MD
Medford Plastic Surgeon

Very hard to remove, but seems like dry eye

The lacrimal gland is located in the outer aspect of the upper eye lid. It has a deep location under the upper bony orbit. It is very difficult to have it injured in a regular blepharoplasty. There are accessory lacrimal glands that are present in the conjunctiva(inner linning of the eye lid). When it comes to dry eye manifestations,it could be related to a combination of eye exposure due to incomplete closure of the eye lid and decreased tear production. Tear production could be... more

Hisham Seify, MD, PhD
Los Angeles Plastic Surgeon

The blink of an eye

Dog, It is unlikely that you had the lacrimal gland mistakenly removed. However, some surgeons will purposely remove or try to resuspend a ptotic or hanging lacrimal gland. Also, dry eyes after an upper blepharoplasty are not uncommon due to the extra exposure of the eyeball to the air. You can have a test done by an ophthalmologist to test the tear production. Natural tears can be used to wet your eyes during daytime hours. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Difficult for surgeon to remove lacrimal gland by mistake

Anatomically, the lacrimal gland is in such a distinct location that it would be difficult for a surgeon to remove it by mistake. My bold assumption is that you experience dry eye complaints after an upper blepharoplasty. These dry eye issues are relatively common and usually temporary. Occurence of dry eyes do not mean that your surgeon did something wrong. It is rather your eyes' response to the eyelid lift.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

Upper Blepharoplasty

The modern upper blepharoplasty relies on removal of excess skin, occasionally obicularis muscle, and rarely fat. Below the upper eyelid muscle and orbital septum, there are 3 compartments - lateral, middle, and medial (closest to the nose). The lateral compartment contains the lacrimal gland, the middle contains a yellowish colored fat pad, and the medial contains a whiter colored fat pad. In the past, many eyelid surgeons removed too much orbital fat. I've seen hundreds of these patients... more

Daniel Reichner, MD
Newport Beach Plastic Surgeon

It is unlikely

It is very rare to remove lacrimal glands. There is a simple test to check tear production.Dry eye post blepharoplasty is common and you may need artificial tear drops for few weeks. I would recommend a consultation with a ophthalmologist to check for dry eye.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Possible for Lacrimal Gland to be inadvertently removed during Upper Blepharoplasty

Fortunately, most doctors who do upper eyelid blepharoplasty afre very acutely aware of the location of the Lacrimal Gland. However, it is not uncommon for the Lacrimal Gland of the upper eyelid to herniate or drop down into the upper eyelid below the protection of the upper bony orbital rim where the gland normally sits. This condition is called Ptosis of the Lacrimal Gland. When this condition is present, the Lacrimal Gland can be very close to and appear to be within the lateral fat pad... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Eyelid surgeons know lacrimal gland should be left alone

Dear Dog As Dr. Berkowitz points out, an eyelid surgeon should know their anatomy and the lacrimal gland should be left alone. Occasionally the lacrimal gland can hang into the upper eyelid making a bulge. This situation is obvious to an experienced oculoplastic surgeon at the time of the pre-operative assessment. The solution is to tack the lacrimal gland back up under the orbital rim. During surgery the lacrimal gland is often exposed in the upper eyelid. However, it is very clear what is... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Lacrimal Gland Should Not Be Removed During Eyelid Lift Surgery

Upper eyelid blepharoplasty or eyelid lift usually consists of removal of excess skin and contouring of upper eyelid fat pads. The upper eyelid has two main pads while the lower eyelid has three. The upper lid pads are medial (closer to the nose) and central (in the center of the eyelid). The third upper lid pad is not fat but the lacrimal gland. The lacrimal gland has a different consistency that fat. An ocular plastic surgeon who specializes in eyelid surgery would definitively know... more